Ethics and Bodywork

TH: You will be running a one-year bodywork course for qualified therapists next autumn. In general what ethical issues will you be considering?

CJ: In a sense, everything I will be teaching will have an ethical aspect. It is important to question yourself about your motives for using bodywork, and to be clear about your own reactions around it. I would also expect participants on the course to be fully informed of the code of ethics relating to their own practice. Obviously, the relevant bodies that accredit therapists will each have their own code of practice in place. This would be the mainstay of any therapeutic practice, including bodywork. More specifically, some of the issues we will be considering will include boundaries, body awareness, respect for the client’s autonomy, reasons for introducing bodywork and personal awareness of the therapist.

TH: Could you say something about your understanding of the term ‘bodywork’, and about particular types of bodywork that need to be considered separately?

CJ: For myself, I would see bodywork as a very inclusive map, ranging from something as simple as asking someone to be aware of their body, moving with their breath, focusing on where the tensions may be felt in the body to bio-energetic work and Reichian bodywork. Bioenergetic work tends to be more prescriptive, in terms of using particular exercises and positions to release held-in energy, muscular and emotional. The bodywork attached to Holotropic Breathwork is usually done in a group setting, though some of the hands-on techniques may be adapted to one-to-one work.

TH: Because some element of touch is common to many bodywork therapies, is it necessary to make this possibility explicit to a client in the initial stages of therapy, or do you see it as something to be negotiated if necessary at a later date?

CJ: I would always use bodywork within the context of the relationship I had built up with the client, so I wouldn’t necessarily be making it explicit in the initial stages. I might however, when describing to a client how I work, include the range of methods that I would offer. Often at that point the client may ask me about bodywork, and I will elaborate on that with them. But that wouldn’t mean that I would intend at that early stage to use bodywork. I would wait until some trust had been established. I would certainly need some knowledge of the degree of ego- strengths in the client, or if they have the inner stability to hold what might come up as a result of the bodywork.

Another thing that would influence my decision to use or refrain from bodywork would be if I sensed there was transference happening. If the client was transferring onto me feelings that came from their early experiences, I would need to be clear what impact my use of bodywork on them might have, and how that might unfold. If I was aware of counter-transference or strong feelings within myself in relation to the client, I would want to be clear that any decision on my part to use bodywork would take that into awareness at the very least. I would need to know that my decision to use bodywork was not coming from a need for myself to express my counter-transference feelings or a need for me to avoid them in myself.

TH: If someone comes to you demanding bodywork, what are the particular considerations that would influence your decision to work in this way or not?

CJ: I would talk through with the client what the demand for the bodywork was about for them, and whether the request for bodywork was expressing a need to avoid contact in the here-and-now on the part of the client with me, or whether that demand was cloaking a need that came from elsewhere, for example, a need for holding from an earlier relationship. I would tend to hold that demand for a time until I had more information and more knowledge of the client, particularly if the demand came early on in therapy. I would tend to see the demand itself as grist to the mill, in terms of opening up what is going on in the therapeutic relationship. Generally I would arrive at the decision to do bodywork in consultation with the client. I would never see it as me making the decision. I would always be offering it as a possibility or as an alternative, rather than prescribing it as something that must be done.

TH: Are there additional difficulties for a bodywork therapist in the event of a client developing a strong sexual attraction for their therapist or vice-versa?

CJ: I think possibly yes, in that you would have an extra-charged situation. I would exercise care and try to be aware how the client might interpret any type of bodywork that might happen. Both myself and the client would need to have the same understanding of what is actually going on. For myself in my own practice, if this situation arose, I think I would probably work with the client in helping them name what was happening for them around that issue, and would work on a verbal or cognitive level with that before using bodywork. From my own point of view as therapist, if such feelings did arise in relation to a client, it certainly would be a time when I would be making very full use of my supervision sessions. I would want to be very clear in myself on what my issues and what my needs were before I would think of using or suggesting bodywork in this situation.

TH: Do you see any potential problems in doing this type of work in one’s home as against the relatively explicit context of working in a therapy centre?

CJ: Having worked from home myself in my earlier years of practice, I would feel that boundaries are particularly important here, especially the physical boundaries that need to be kept clear around the work space. As well as being physically separate from the rest of the therapist’s home, it would be desirable that noise from home life should be kept to a minimum. Obviously it would be essential that privacy be afforded to the client in terms of what is discussed being overheard. I think it is important too that the setting allows the therapist to be at ease with any noise that might ensue as a result of bodywork.

TH: How important is one’s own physical process in this type of work?

CJ: I would consider it very important that someone who is doing bodywork would have a knowledge from the inside of their own body process and have done a considerable amount of bodywork for themselves. It makes sense that as a therapist I am aware of my own body responses as well as my emotional responses. Having an awareness and an ease with my own body process allows me to use what’s happening in my own body as an information source for myself and also at times for my client. I need also to be in touch with my own physical tensions and vulnerabilities in order to be able to take care of my body and avoid a build-up of stress which may lead to burn-out.

Caitriona Jackson trained in Humanistic & Integrative Psychotherapy in Dublin and in Holotropic Breathwork with Stanislav and Christina Grof in the US. She is co-founder and co-facilitator of AISTEAR, a centre for Humanistic & Integrative Psychotherapy and Counselling.